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Shift work, sleep quality, and worker health: a study of police officers.

The Planning and Analysis Unit of the Lexington Police Department changed from rotating to permanent shift assignments. We report herein the results of patrol officers' responses to the Florida Sleep Questionnaire, the SCL-90 (a symptom checklist), and absentee data. Sleep quality and sleep hygiene improved after changing from rotating to permanent shifts. The SCL-90 demonstrated improved psychologic well-being. Further, absentee rates fell from 1400 hours during the 6 months preceding the shift change to 883 hours during the 6 months following the change. We review the literature concerning the effects of shift work on worker performance.

Absenteeism↗

Comparison of spinal health indicators in predicting spinal status in a 1-year longitudinal study.

A 1-year longitudinal study was performed to assess and compare the predictive qualities of spinal health indicators (excluding the cervical spine) among aircraft assembly workers having at least 1 year seniority in a large assembly plant. Ten health indicators were compared to determine their sensitivity and predictive power with regard to back compensation and absenteeism in 12 months follow-up, and the presence of any limitation at work due to the back, or symptoms to the back at the end of the interval. The initial response to a self-administered questionnaire was obtained from 269 male workers, of whom 205 (76.2%) completed the follow-up questionnaire. Initial prevalence of symptoms to the back was 42.3%, limitation in performing at work was 28.1%, consultation of a health professional was 7.3%, and a history of compensation for the back (ever) was reported by 30.4%. During the year of follow-up, 16 (6%) of the 269 workers initially enrolled were granted 17 compensated episodes. Of the 205 workers who responded to the follow-up, 33 (16.1%) have been absent from work (with or without compensation) because of their back. The presence, at the beginning of the study, of a limitation in performing at work or in activities of daily living and a history of compensation (ever) were the three indicators independently associated with the occurrence of compensation or absenteeism (total work disability) related to a back problem during the following year.(ABSTRACT TRUNCATED AT 250 WORDS)

Absenteeism↗

Occupationally-sponsored, community-provided hypertension control.

A hypertension control program established by the Massachusetts Mutual Life Insurance Company in 1977 included education, on-site case finding, and referral to community physicians with a company-based follow-up system facilitated by assumption of all costs by the company. Ninety-eight percent (2, 463) of the employees were screened; 11% (277) had hypertension. Of these, 59% were in treatment and 36% were controlled at entry. More than 84% of the hypertensives accepted referral to care and 79% fulfilled all program requirements. By the fifth program years, 70% had achieved blood pressure control. Mean blood pressure declined from 150/93 to 142/88 mm Hg. Absenteeism for all hypertensives averaged 4.7 in the three years before and 5.7 during the four years of the program. Employees active in the program had fewer average days of absenteeism (4.7) than inactive participants (6.8). Modest cost and a favorable employee/physician response has made this a highly acceptable as well as an effective company health program.

Absenteeism↗

Cost-effectiveness of the influenza vaccine in a healthy, working-age population.

To determine if the influenza vaccine can reduce absenteeism and the cost of Influenza-Like Illness (ILI) in healthy adults in the workplace, a prospective, non-randomized, non-placebo control trial was done in six North Carolina textile plants. One hundred thirty-one vaccinated employees were compared with 131 age- and gender-matched non-vaccines from different plants. Twenty-six (20%) of the vaccinated and 64 (49%) of the unvaccinated group had ILI (P = 0.0000008). Fifteen (11%) of the vaccinated and 31 (24%) of the unvaccinated employees missed work because of ILI (P = 0.01). There were 43 lost workdays in vaccinated and 93 in unvaccinated employees (P = 0.00004). The "cost per saved lost workday" was $22.36, for a company savings of $2.58 per dollar invested in the vaccination program. We concluded that the influenza vaccine can give significant reductions in incidence, absenteeism, and cost associated with ILJ in the workplace.

Absenteeism↗

The role of health risk factors and disease on worker productivity.

The costs attributed to employee health problems are usually measured by employers in terms of direct health care costs, such as medical plan claims. Although it has been understood that employee health problems also produce indirect costs for employers, their measurement has been far less frequent. At best, studies have recorded one component of indirect health costs: the time lost to employee absenteeism and disability. The study presented here includes a measure of the actual decrease in the productivity of employees while they are on the job, in addition to measures of absenteeism and disability. These three measurements were combined to produce a Worker Productivity Index (WPI). The WPIs of 564 telephone customer-service agents were correlated with the employees' number and type of health risks, as measured by a Health Risk Appraisal. Additionally, the WPI was also examined across different disease states in the same population of employees. As the number of health risks increased, an employee's productivity decreased. The nature of the health risk may also differentially affect the pattern of the decrease. Finally, disease states were also associated with different patterns of productivity reduction.

Absenteeism↗

Financial incentives, participation in employer-sponsored health promotion, and changes in employee health and productivity: HealthPlus Health Quotient Program.

Employer-sponsored health promotion can improve employee health and morale and reduce medical claims and absenteeism. Effectiveness depends on the participation of those employees who are at increased risk of ill health. HealthPlus Health Quotient is an incentive/disincentive approach to health promotion. The employer's contribution to the employee cafeteria-plan benefit package is adjusted on the basis of an annual health risk appraisal. We evaluated whether this financial incentive/disincentive predicted participation in health promotion activities, and whether participation improved future health risk and productivity. In the first year, participation was proportional to overall health risk (P < 0.01). Participation in targeted programs was proportional to levels of body fat, cholesterol, and blood pressure. Participation in activity-related health promotion was proportional to prior-year activity or fitness scores. Health promotion participants improved their subsequent-year health risk more than did non-participants. Participation was associated with reduced illness-related absenteeism and (although inconsistently) with medical claims paid and short-term disability.

Absenteeism↗

Health, safety, and productivity in a manufacturing environment.

The Health and Productivity Management model at International Truck and Engine Corporation includes the measurement, analysis, and management of the individual component programs affecting employee safety, health, and productivity. The key to the success of the program was the iterative approach used to identify the opportunities, develop interventions, and achieve targets through continuous measurement and management. In addition, the integration of multiple disciplines and the overall emphasis on employee productivity and its cost are key foci of the International Model. The program was instituted after economic and clinical services' analyses of data on International employees showed significant excess costs and a high potential for health care cost reductions based on several modifiable health risk factors. The company also faced significant challenges in the safety, workers' compensation, and disability areas. The program includes safety, workers' compensation, short-term disability, long-term disability, health care, and absenteeism. Monthly reports/analyses are sent to senior management, and annual goals are set with the board of directors. Economic impact has been documented in the categories after intervention. For example, a comprehensive corporate wellness effort has had a significant impact in terms of reducing both direct health care cost and improving productivity, measured as absenteeism. Workers' compensation and disability program interventions have had an impact on current costs, resulting in a significant reduction of financial liability. In the final phase of the program, all direct and indirect productivity costs will be quantified. The impact of the coordinated program on costs associated with employee health will be analyzed initially and compared with a "silo" approach.

Absenteeism↗

The economic burden of lost productivity due to migraine headache: a specific worksite analysis.

Large, epidemiologic survey studies have established that migraine headaches affect approximately 6% of men and 18% of women in the United States and that the condition peaks during the prime working years (25 to 55 years of age). The consequent economic burden experienced by employers is substantial. The majority of this economic burden is realized by employers in terms of lost productivity, a combination of costs attributable to absenteeism and to lost productivity while on the job ("presenteeism"). Although large survey studies have produced estimates of national prevalence and have suggested substantial national costs, specific employers are rarely able to apply these projections to their specific workforce. Using demographic and payroll data available from a large financial services corporation with over 80,000 employees, this study used established prevalence data to estimate corporate costs stemming from migraine-related absenteeism and reduced on-the-job productivity to total at least $21.5 M and $24.4 M. In addition, a comparison of predicted prevalence and cost impact was conducted using a simpler and less costly health risk appraisal. This assessment proved to be a reliable tool in assessing prevalence of migraineurs in this corporation's workforce. Its use with a sample of 19,853 employees at this corporation produced prevalence rates of 7.7% of men and 23.4% of women, estimates closely comparable to those of national surveys. Suggestions are made regarding a corporate response to the substantial costs of lost productivity associated with migraine headache.

Absenteeism↗

Validation of the Health-Related Productivity Questionnaire Diary (HRPQ-D) on a sample of patients with infectious mononucleosis: results from a phase 1 multicenter clinical trial.

The objective of this work was to assess the performance of the newly developed Health-Related Productivity Questionniare-Diary (HRPQ-D). Patients completed the HRPQ-D daily for 1-week periods during weeks 1, 2, 4, and 8 of a clinical trial for infectious mononucleosis. Productivity data were collected on a daily basis in terms of absenteeism, presenteeism, and combined lost productivity for three work venues (work outside home, housework, and classes/homework). These were then correlated with patient symptom scores. Symptom scores were positively correlated with lost work hours because of absenteeism and combined lost productivity scores. However, negative correlations were observed between symptom scores and the lost work hours due to presenteeism. The HRPQ-D demonstrated good construct validity, making it a useful tool for determining productivity levels across different work venues within clinical trial or survey research applications.

Absenteeism↗

The burden of allergies--and the capacity of medications to reduce this burden-in a heavy manufacturing environment.

This article addresses the observational findings of the first systematic study undertaken by a manufacturer to address the impact of allergies and use of allergy medications on health, safety, and productivity. It provides background for 3 other papers from the same project, including an evaluation of an intervention to promote appropriate medication use among affected employees, which appear in this issue. The observational data are developed on 10,714 employees from: 1) 2 employee surveys; 2) administrative databases monitoring employee absenteeism, workers compensation, short-term disability, and group health. The results show that health, productivity, absenteeism, workplace injury, and workers compensation measures register consistent declines as allergy severity levels increase. This pattern is present but less pronounced for the short-term disability and group health measures. In addition, among the 16 measures registering a significant allergy burden, 6 posted significant advantages for the use of nonsedating antihistamines relative to other medication regimens that included sedative antihistamines. These results document the burden of allergies and the capacity of medications to reduce this burden. Effective intervention programs that target this condition can achieve improved health, productivity, and related outcomes.

Absenteeism↗

A prospective assessment investigating the relationship between work productivity and impairment with premenstrual syndrome.

Our objective was to assess life domain and work-related impairment in patients experiencing premenstrual syndrome (PMS). A sample of women, 18 to 45 years of age, completed the Daily Rating of Severity of Problems Form to record daily symptoms for two consecutive menstrual cycles. In the workplace, women with PMS reported higher absenteeism rates (2.5 days vs. 1.3 days; P = 0.006) and more workdays with 50% or less of typical productivity per month (7.2 days vs. 4.2 days; P < 0.0001). Women with PMS in one of two menstrual cycles reported a greater number of days with impairment in routine work, school, and household activities in comparison with women without PMS. Results indicate that PMS leads to substantial im in normal daily activities and occupational productivity and significantly increased work absenteeism.

Absenteeism↗

The relationship between health risks and work productivity.

We sought to provide evidence for the relationship between health risks and self-reported productivity, including health-related absence and impaired performance on the job. A cross-sectional analysis was implemented consisting of 2264 employees of a large national employer located in the Northeast. Participants responded to a health risk assessment and work productivity scale. Mean productivity loss was compared for individuals with different levels of risk factors using analysis of variance. Multivariate analyses, including logistic and linear regression, were used to determine the significance of health risks on productivity loss. Participants with more risk factors reported greater productivity loss (P < 0.001). The odds of any productivity loss were most significant for individuals with diabetes (absenteeism) and stress (presenteeism). In conclusion, higher risks are strongly associated with greater productivity loss, and different risks are associated with absenteeism than with presenteeism.

Absenteeism↗

The impact of a prospective survey-based workplace intervention program on employee health, biologic stress markers, and organizational productivity.

OBJECTIVE: To study whether knowledge about psychosocial work indicators and a structured method to implement changes based on such knowledge comprise an effective management tool for enhancing organizational as well as employee health and well-being. METHODS: White- collar employees representing 22 different work units were assessed before and after a 1-year intervention program. Subjective ratings on health and work environment, biologic markers, absenteeism, and productivity were measured. RESULTS: Significant improvements in performance feedback, participatory management, employeeship, skills development, efficiency, leadership, employee well-being, and work-related exhaustion were identified. The restorative hormone testosterone increased during the intervention and changes correlated with increased overall organizational well-being. Absenteeism decreased and productivity improved. CONCLUSIONS: Fact-based psychosocial workplace interventions are suggested to be an important process for enhancing employee well-being as well as organizational performance.

Absenteeism↗

Gender difference on the symptoms, health-seeking behaviour, social impact and sleep quality in irritable bowel syndrome: a Rome II-based survey in an apparent healthy adult Chinese population in Taiwan.

BACKGROUND: Little is known about the gender effect on irritable bowel syndrome in Asia. AIM: To assess the gender difference in Chinese subjects with irritable bowel syndrome meeting Rome II criteria. METHODS: Irritable bowel syndrome was identified from an apparently healthy adult population receiving a routine health maintenance program (n = 2018). RESULTS: Female gender is not a factor associated with irritable bowel syndrome or irritable bowel syndrome-related health care-seeking behaviour. Female irritable bowel syndrome subjects, irrespective of consulting behaviour for irritable bowel syndrome, are likely to have < 3 bowel movements/week, hard/lumpy stools and abdominal fullness/bloating (P < 0.05). Female irritable bowel syndrome subjects are prone to be absent from school/work with more days of absenteeism, irrespective of consultation status (P < 0.05). Only female irritable bowel syndrome consulters have more absenteeism for their irritable bowel syndrome-related symptoms, reporting more sleep disturbances than their male counterparts (P < 0.001). CONCLUSIONS: In an apparent healthy adult population in Taiwan, gender difference is present in Rome II defined Chinese subjects with irritable bowel syndrome as regards bowel symptoms, social impact and sleep quality. Female predominance was not found in irritable bowel syndrome subjects and irritable bowel syndrome-related health care-seeking behaviour in the current population. Both irritable bowel syndrome non-consulters and consulters have similar gender difference profiles in presenting symptoms, suggesting that bowel symptoms per se may not be the only factor leading to health care-seeking behaviour. The gender differences in sleep problems were observed solely in irritable bowel syndrome consulter.

Absenteeism↗

Social and medical impact, sleep quality and the pharmaceutical costs of heartburn in Taiwan.

BACKGROUND: Little is known about the social and medical burdens of heartburn in Asia. AIM: To assess the impact of heartburn in Taiwan. METHODS: We applied a questionnaire to 2018 apparently healthy adult Chinese receiving a routine health maintenance programme. Costs of heartburn-related prescriptions were obtained from the Bureau of National Health Insurance of Taiwan. RESULTS: Heartburn prevalence (>1 episode/week) was 7%. Smoking and increased body mass index were associated with heartburn occurrence. Heartburn sufferers reported more atypical gastro-oesophageal reflux disease symptoms, e.g. chest pain, dysphagia and globus. They were more likely to consult physicians, and have an increased frequency and number of days of absenteeism, irrespective of upper gastrointestinal or nongastrointestinal-related illnesses. They experienced sleep disturbances more frequently. The 62 heartburn consulters (48%) were more likely to have co-existing globus, visited physicians more, had more absenteeism, suffered from more sleep disturbances and had higher costs for antacids, proton pump inhibitors, hypnotic/sedatives, tranquilizers and antidepressants than nonconsulters. CONCLUSIONS: Heartburn prevalence in Taiwan is lower than in Western countries. Nevertheless, heartburn in Taiwanese creates a significant burden in terms of social impact, health resource utilization, sleep quality and pharmaceutical costs. The increased costs of psychoactive drugs in consulters suggest that anxiety/depression affects their health-seeking behaviour.

Absenteeism↗

Improving the psychosocial work environment.

AIM: This paper reports a pilot project to evaluate the effectiveness of a participatory organizational intervention to improve the psychosocial work environment in one long-term care unit. BACKGROUND: Since the early 1990s, health care institutions in Quebec have been constantly changing in order to improve the efficiency of the health care system. These changes have affected the work environment and have contributed to higher rates of burnout and absenteeism among nurses and other health care workers. METHOD: The study participants were health care workers in a long-term care unit (n = 60). The participatory organizational intervention was based on a contract and carried out by a work team. Work constraints were identified, and an action plan implemented, The effectiveness of the intervention was evaluated by pre- and postintervention questionnaires: the Job Content Questionnaire, Effort-Reward Imbalance Questionnaire and Psychiatric Symptom Index. RESULTS: There was a significant increase in reward (P < or = 0.01) and a significant decrease in Effort-Reward Imbalance (P < or = 0.01) following the intervention. Absenteeism rates decreased from 8.26% to 1.86% over the study period, but in the rest of the institution remained the same. However, there was a significant decrease in social support from supervisors (P < 0.05) at post-test. CONCLUSION: Participation by health care workers and action plans targeting problematic aspects of the psychosocial work environment are key elements in interventions to improve their health. However, such interventions present challenges, such as the involvement of managers, involvement of all relevant participants, and re-establishment of trust within work teams. Recognition and respect must be re-established, and supervisors must engage with health care workers and give support at all stages of the intervention.

Absenteeism↗

Linguistic validation of the US Spanish work productivity and activity impairment questionnaire, general health version.

INTRODUCTION: There are no measures of health-related absenteeism and presenteeism validated for use in the large and increasing US Spanish-speaking population. Before using a Spanish translation of an available English-language questionnaire, the linguistic validity of the Spanish version must be established to ensure its conceptual equivalence to the original and its cultural appropriateness. OBJECTIVE: The objective of this study was to evaluate the linguistic validity of the US Spanish version of the Work Productivity and Activity Impairment questionnaire, General Health Version (WPAI:GH). METHODS: A US Spanish translation of the US English WPAI:GH was created through a reiterative process of creating harmonized forward and back translations by independent translators. Spanish-speaking and English-speaking subjects residing in the US self-administered the WPAI:GH in their primary language and were subsequently debriefed by a bilingual (Spanish-English) interviewer. RESULTS: US Spanish subjects (N = 31) and English subjects (N = 35), stratified equally by educational level, with and without a high school degree participated in the study. The WPAI-GH item comprehension rate was 98.6% for Spanish and 99.6% for English. Response revision rates during debriefing were 1.6% for Spanish and 0.5% for English. Responses to hypothetical scenarios indicated that both language versions adequately differentiate sick time taken for health and non-health reasons and between absenteeism and presenteeism. CONCLUSION: Linguistic validity of the US Spanish translation of the WPAI:GH was established among a diverse US Spanish-speaking population, including those with minimal education.

Absenteeism↗

Helicobacter pylori eradication treatment does not benefit patients with nonulcer dyspepsia.

OBJECTIVES: The aim of this study was to assess the still controversial role of treatment of Helicobacter pylori (H. pylori) infection in patients with nonulcer dyspepsia. METHODS: We conducted a double-blind, randomized, placebo-controlled, multicenter trial comparing the efficacy of 7 days of eradication treatment (lansoprazole 15 mg b.i.d., amoxicillin I g b.i.d., and clarithromycin 500 mg b.i.d.) with a control treatment (lansoprazole 15 mg b.i.d. and placebo) in H. pylori-infected patients with nonulcer dyspepsia. 13C breath tests were performed at baseline and during follow-up. We assessed patient symptoms, health status (based on the SF-12 questionnaire), patient satisfaction, drug consumption, health care consultation behavior, and absenteeism related to dyspepsia over a 1-yr period. RESULTS: A total of 74 patients randomized to eradication treatment and 70 patients randomized to placebo were compared. The rate of eradication of H. pylori infection was 75% in the active treatment group and 4% in the placebo group (p < 0.005). The symptom score improved to a similar extent in the group receiving active treatment (-4.0; 95% CI = -5.0 to -3.0) and placebo (-3.6; 95% CI = -4.5 to -2.7). Treatment response was not related to the severity or duration of initial symptoms or to the severity of gastritis on histology. Quality of life scores were comparable at 12 months. There was no significant difference in dyspepsia-related absenteeism or satisfaction with management of NUD. Patients receiving active treatment were more likely not to have had to use any dyspepsia treatment over the 12 months (60.8% vs 44.3%; p = 0.047). CONCLUSIONS: This study did not demonstrate any substantial benefit of curing H. pylori infection in patients with nonulcer dyspepsia. The study adds further evidence that H. pylori is not the main pathogenetic or therapeutic target in these patients.

2-Pyridinylmethylsulfinylbenzimidazoles↗